$40 million sounds like a lot to spend for marketing. However, healthcare system is broken and a huge issue for both individuals and businesses alike. Neither the insurance companies or the government are capable of fixing healthcare on their own; if people get together and organize, hopefully we can "steer" the government in the right direction. Most Americans don't expect the government to pay for their healthcare, they just want it to be portable and affordable. There should be some efficiencies if all Americans can be under a "universal healthcare program", a program that encourages Americans to take responsibility for their their health first of all, and if hey need to go to the doctor or get prescriptions they can afford to.

Paul,

You hit on a MAJOR point: People taking responsibility for their own health. Many people in this country who have insurance will only seek health care once they are facing a crisis. Often, the crisis could have been totally averted if the person in question had simply taken more preventative measures (eat right, exercise more, etc).

We also have a major perspective problem: We get sick and we ask for a prescription. Sometimes we really do need the medicine (i.e. infections and cancer treatments come to mind), but other times we take the medication because that is easier than making changes to our lifestyle (cholesterol lowering meds)or accepting that medicine won't help (antibiotics for a cold virus).

We can't really blame only the insurance companies as we are part of the problem (we want every and any procedure regardless of how much it will or won't help. Someone has to pay for it). The government also is part of the problem with pricing for medical goods and services.

Frankly, considering that government does not even fund CURRENT programs and that the bureaucracy of those programs is labyrinthine do we really want government running another program?

The private sector ain't perfect, but the government is even less so.

Here is also something to consider: Every government program currently in existence has regulations to qualify, what coverage or services will be provided, who can provide those services or coverage.

Do you NOT think, government run health care system would also have its own regulations? Do you really want the government having MORE control over what services, procedures, medications, personnel that YOU have access to? One of our inalienable rights as humans is liberty. This kind of control doesn't look like liberty to me.

I have experienced military health care, Canadian health care and Tricare along with private care. Do you really think government care is bad if all our elected officials use it on our dollars? Government care is as good or as bad we support and demand the same as private care. The difference is non-profit!!! If we get rid of paying middlemen for-profit insurance companies and for-profit pharmaceuticals, and push preventive care and health education, we will be a healthier country. No one should lose their home and care because of emergency illness. That hurts families and work places. It's nuts!

Health insurance does not equate to good health. As noted above, we could have a much healthier society if people ate better, exercised and slept more, and gave up smoking.

As the government can't afford Medicare currently, I think it is ambitious to think it could afford universal coverage. What the government can, and should, do is:

1. Level the playing field for insurance companies so that 'cherry-picking' of the healthiest patients to insure is eliminated.
2. Provide an affordable catastrophic coverage plan for everyone - no one should ever go broke from healthcare bills.
3. Incentivize 'healthy' habits: for example, a premium reduction could be achieved by stopping smoking, lowering cholesterol, or keeping blood sugar levels in better ranges.
4. Eliminate the confusion in health insurance: plans should be easy to understand what is covered and what is not. Your plan should be fully portable from one insurance company to another.
5. Create a central clearinghouse (not necessarily a single payor) for all insurance claims for providers. Eventually something like this has to happen as the complexity of the system has grown immensely. At this rate, doctors will eventually bill patients directly and patients will submit their bill to insurance companies for reimbursement (like dental insurance).

There are ways to improve the healthcare problem in a non-partisan way if the political will is present.

Using that money to build hospitals and clinics that people cannot access does not make sense. There are already many hospitals and clinics in operation. The problem is that the people who do not qualify for Medicaid, Medicare, or private health insurance cannot use them and, although in an emergent situation they cannot be turned away, some are, in fact, turned away or "dumped" by refusing admit and shuttling them to county tax supported institutions. Either way, in a crisis, everyone will get the care they need and we all pay for it, one way or another, and pay more because it is complex care with complications than it would have been if it had been preventative care or care provided before it became a crisis. A healthy America with healthier choices and life styles requires an America where everyone has access to preventative care that includes education, self care, motivation, follow up, and for those who have less than, a feeling that someone cares about the choices they make and promotes accountablility.

If you are over 65 and live in some states, you may already be experiencing doctors who will not accept Medicare, which you are required to pay into every month and is taxed to boot. Good luck if you can't pay $100-$200 to see an internist or family specialist for 15 minutes for non emergencies and preventive care. Of course, you can go to an emergency room with your allergies, as recommended by our president, and we will all pay your sky-high bill from there. In fairness to the docs, the government does not reimburse their services fairly or efficiently. Patients and physicians are both caught in a trap set by the pharma and insurance companies.

Our health system is at a crisis point. If you haven't been caught up in it, yet, you are young or very, very lucky. It will catch up with you.

Spence,

You are exactly right. Many practices don't take Medicaid, or limit patients they see with Medicaid, because the care comes at the expense of the practice. With current and proposed cuts in Medicare, the same is going to be happening. It won't hit home with many people until they try to make grandma an appointment and it takes three months for her to be seen.

For those who don't think this will happen, ask yourselves if you expected $4/gallon gasoline two years ago...

The single greatest problem in getting to universal coverage is the failure to control the rate of rise of healthcare costs. These costs have risen much higher than the rate of inflation in all developed economies for the past 20 years. Until someone figures out how to control these costs, universal coverage will not be affordable. There are some painful choices to make, but if made, we can all have decent healthcare insurance.

Common Sense:

You have none. "This is just another socialist program that everyone must pay for, even those who can not afford to pay for more freebies for irresponsible people. When is it going to stop???????"

I've paid over $100,000 in medical insurance premiums over my lifetime and received less than $10,000 in benefits. Who pocketed $90,000+? The executives and shareholders of insurance companies. If I'm going to pay that much for medical insurance, I want my money to be put to good use. Not to buy a new yacht for some greedy ass. Eliminate middlemen and you lower the cost of health care for everyone.

We do not have to provide carte blanche health care, but very good preventive and basic care with catastrophic coverage. No one should go bankrupt from a heart condition.

Perhaps there would be elective surgeries, a cap on pre-natal and maternity care, no botox coverage, etc. In other countries, the care is often much better than the surroundings -- enough of fancy birthing centers, unless you can pay for them. Babies are successfully born in no-frills military hospitals every day. It is having competent care when you need it that matters.

Neighborhood quick stop clinics could absorb many costs of elegant medical suites for vaccinations, flu checks, ear aches, broken arms, etc.

There is one and only one natural leader of this campaign, that would be Hillary Clinton. I'd like to see her get back in the campaign myself. Since Obama reversed his position on campaign financing, Hillary should use this as a reason to reverse her withdrawal from the race. She should come out slamming Obama for his hypocrisy.
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Clinton, save us from Obama, please!!!!
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doc, you make some great, common sense suggestions. Way too rational; therefore, it will never fly with Congress. Not enough in it for them; they could lose big industry donors.

America's health care system is an international joke; the government has no problem running a police force, fire department. Are these anti-liberty organizations too?

There are more than 14 illegal immigrants in this country and when they have an emergency or medical problem, they rush to the local hospital. This can anything from childbirth, car wreck, a broken bone or even a bee sting. All of these people get necessary care and walk out without paying. This is costing billions and some hospitals have closed. But if you are a poor citizen, you will be billed or hounded for years to get the bill paid. Is that fair? I think not.

In Alaska there is no three months wait for Medicare patients. There are no internists willing to accept Medicare and many patients now must go to nurse practitioners instead of the internist they saw for many years. It's coming folks to wherever you live because it doesn't pay to be a family physician and there are not enough of them.

Do you have friends going to Bangkok and Mexico for health care like knee replacements and endodontics? It's happening because care here has become unaffordable for many, regardless of insurance. Isn't that a wonderful commentary on our system?

They havent endorsed anyone????

"Health Care for America NOW suggests three options to achieve universal health coverage. Individuals can stay with the private insurance they already have, join a new private insurance plan or choose a public health insurance plan."

Sounds like Obama and Hillary's plans!!

"Uh.. the reason it's called health "insurance" is because you pay premiums, betting that if you do get very ill, your insurance benefits will outweigh the premiums you've paid."

You missed the point Spence. I was talking about insurance co's, pharmaceuticals and doctors treating medicine like a business and trying to get rich off of it. Health care should be treated like other basic services, such as police and firefighters. Eliminating the profit factor, i.e. the middlemen, will go a long way in reducing costs.

Healthcare is a passionate issue but so little understand the real facts. 5% of the US population accounts for 60% of the total healthcare spend, which is $2Trillion annually. There are 5 major diseases that account for 70% of total healthcare spend. 1)Diabetes (now 8% of US!!??) 2)Asthma 3)Congestive Heart Failure 4)Arterial Sclorosis 5)Depression. If you have 2 or more of these diseases that is classified as "comorbidity". That is about 3% of the population driving the undisputed overwhelming majority of the healthcare dollars spent. In order to fix healthcare, you have to fix the way this comorbidity population recieves care. Because each of the 5 diseases have their own "specialist", meaning you don't see a town physician for Diabetes, a comorbid patient has 2 patients, who don't communicate with each other about the patient they share, they keep their records in paper files, so one doctors perscriptions can negatively interact with anothers causing hospitilization and fatalities each year. Finally, our system is set up to treat, not to prevent. There are 9,000 billing codes for a procedure performed but not 1 for a cure - make sense? If little jimmy has asthma, his asthma specialist treats asthma attacks, but has no financial incentive to prevent jimmy from having an asthma attack in the next year. Not blamming docs, it just is what it is. If the docs could bill for preventing attacks, they would follow up with his mother to make sure he was taking his meds and they had gotten rid of the cat, etc. Right now, health plans are the one's that are providing the care management role in this country. If you have insurance and are diagnosed with Diabetes, your plan will have a contracted Wellness program cotact you to educate you about your disease and make sure you have coaching and sources for information, which is CRITICAL! You can't replace plans without replacing that function, which makes us unique from government provided models. Everyone wants health insurance for everyone, and if you actually take time to listen to what the plans are saying, they have offered several reasonable proposals to get universal coverage. Making them the scapegoat for the problems in healthcare is like putting duct tape on the 50ft breaches in the damn. That said, there is no questioning that some plans have made some horrificly poor decisions that should anger every American, and in this media cycle, they feel public pressure every time that happens. But don't just put the blame there - for god sakes, a woman died on the floor of hospital 2 weeks ago. She sat there for hours unattended by hospital staff, who never seem to be the most proactive group on the whole. Also, Americans want to eat double cheeseburgers and drive everywhere. For god sakes, who do you think created the child obesity epidemic taking place today?? Congress? Pharma companies? Plans? No. None of the above. We did. We just dont like to be told to look in the mirror. Its much easier to blame lawyers, plans, congress, or whoever you think should be paying your bills. Until Americans share in the financial responsability of their health, we will struggle. As a final note, if you think the poor in this country are ready to sign up for health insurance you are sadly mistaken. Medicaid has problems trying to get people to enroll. They're typically very difficult to reach and for the most part, only show up in the healthcare system when they arrive at the ER needing care. If you're wondering, I think both McCain and Obama's plans will help, but neither will fix healthcare - this requires fundamental changes well beyond presidential politics, if you can imagine that.

One major point to keep in mind when considering what kind of universal health care we want: The private insurers (HMOs, PPOs etc.) spend 25%-30% of their premium dollars on bloated executive salaries and other overhead, dividends to shareholders, and hugely expensive TV ads (seen those gazillion AARP ads, pushing their insurance plans?)Medicare, by contrast, spends about 4-5% of their premium dollars on overhead.
The difference between an overhead of 25-30% and 4-5% amounts to BILLIONS of dollars every year that could be used to make Medicare available to all who want it (subsidizing low-wage families), and also to improve the coverage (20% of each claim has to be paid by the insured, unless you have "Medigap" insurance too.)

Ann's post is perhaps one of the most common misunderstood arguments in healthcare. See this article in the NY Times for a much better understanding.

http://www.nytimes.com/2007/03/22/business/22scene.html?_r=2&adxnnl=1&oref=slogin&adxnnlx=1196457218-1blh0jchZBQEkjr1R5pryg&oref=slogin